Fertility on ice

When you're 37 and stressed about making babies, egg freezing offers hope.

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Three weeks before my 37th birthday, a good friend called me in tears. After two years of trying to get pregnant, she’d learned her ovaries had shut down. At 38, she had to accept that it was too late for her and her husband to have a child with her own eggs. Not even advanced fertility treatments would help.

I was sad for my friend, but I was also scared for myself. One year shy of 38, I didn’t have a partner in sight. I was also broke and starting a new career, so I wasn’t exactly a candidate for single motherhood. But what were the odds I was going to meet someone and have a child while my ovaries were still viable?

When you’re single in your 30s, the question of kids—if, when, how many—comes up early in any serious romantic connection. I had a pat response: With the right person at the right time, I’d love to have a child or two. But it wasn’t something I’d go to extremes for. As a writer living in New York City, I was surrounded by single people, and I’d heard plenty of stories about thirtysomething women in the throes of baby panic who made rash decisions, marrying the wrong guy or getting knocked up by an unwitting fellow who then quickly ran for the hills. I’d catch myself looking around tiny Manhattan apartments and wondering, Where do you even put a baby in this city?

But when a choice may no longer be yours to make, your imagined fate can appear in stark relief. In the wake of my friend’s news, I started to remember all the times I’d pictured my own kids, the places I’d show them and the stories I would tell them—how the most trying moments of my life would become more meaningful when I had kids to put it all into perspective. Men take it for granted that they will always be able to have children. Would they date someone whose window had already closed?

With my thoughts sending me into a tailspin, I went online. I’d heard about egg freezing in the late 1990s while researching future fertility treatments for an article I was writing, so I was excited to discover a local clinic was now offering the procedure. Had the future already arrived? I booked a consultation with the clinic to investigate.

Doctors have been freezing sperm for about 50 years, but egg freezing is still considered experimental by some and reserved mostly for young cancer patients facing fertility-threatening chemotherapy. In the past six years, however, some clinics have started marketing the procedure to women concerned about running out of time to have kids—albeit with controversy. The American Society for Reproductive Medicine, an organization of reproductive specialists in Birmingham, Alabama, asserts that the procedure “should not be offered as a means to defer reproductive aging,” claiming that the current data is too limited to consider egg freezing an established treatment. “It’s hard to justify having a $15,000 to $20,000 procedure when there’s a very small chance it will work,” explains David Adamson, M.D., president of ASRM.

Yet although the number of births from frozen eggs per clinic remains low, some of the top centers are offering very good odds for success. For instance, at New York University’s Fertility Center in New York City, which launched its egg-freezing program in 2005, center director Jamie Grifo, M.D., estimates that women ages 35 to 37 have a 46 percent chance of having a baby after a cycle of egg freezing with thaw, fertilization and transfer, and those ages 38 to 40 could expect a 36 percent chance of success. That may sound low, until you consider that the odds of getting pregnant the old-fashioned way, during peak fertility years, are only 10 to 12 percent per ovulation cycle.

“Very few fertility clinics have invested their energy and money in successfully developing the technique of egg freezing, so the ASRM is worried about backlash from unhappy patients who freeze their eggs and aren’t successful,” says Dr. Grifo, who is also a past president of the Society for Assisted Reproductive Technology, an ASRM affiliate. He agrees with the ASRM that prospective patients must be thoroughly informed about the procedure, including the clinic’s experience with actual pregnancies, as well as about alternative options.

I learned in my research that the technique used to harvest a woman’s eggs for freezing is the same one used during in vitro fertilization: A woman injects herself with hormones to stimulate egg production. Then a doctor uses a needle to extract each egg. Supercharging the ovaries with hormones did not sound risk-free to me. But the American Cancer Society in Atlanta has reported no increased risk for breast or ovarian cancer from a single cycle of injections. One documented risk, occurring in about 0.5 percent of IVF cases, is hyperstimulation syndrome, in which the ovaries become dangerously enlarged, in rare cases requiring their removal.

Egg harvesting may be fairly routine, but the freezing process is not. Unlike sperm, a mature egg cell is large, and unlike embryos, egg cells contain a lot of water. This means ice crystals can form and cause damage, preventing the egg from eventually being fertilized or from dividing properly once fertilization takes place.

Still, thanks to recent improvements to the procedure, including use of a quick-freeze technique known as vitrification, top docs are optimistic about its efficacy and safety. At least 550 babies have been born from frozen eggs, and recent research, presented at the annual ASRM conference, tracked 517 of these children and found that the rate of genetic abnormalities was the same as in children conceived naturally.

When I began my exploration, none of the clinics near me had reported any pregnancies. Casting a wider net, I found the Florida Institute for Reproductive Medicine (FIRM) in Jacksonville, which first began freezing eggs in 1997 and has delivered 53 babies from once-frozen eggs to date. The stats on its website drove home the point that time was of the essence: The younger you are, the more likely you will ovulate a bunch of healthy eggs to begin with, leaving more to work with after the freezing and thawing process. Some clinics won’t take women who are older than 37, as this is the age when egg production and IVF success rates start to drop rapidly.

FIRM’s fees were nearly $7,600 per cycle, not including the roughly $1,500 for the testing and monitoring I’d need to undergo before the procedure (only some of which my insurance would cover), $2,000 more for medications and $2,000 to $4,500 to one day thaw, fertilize and implant the eggs. And some women need two cycles to produce the dozen or so mature eggs needed for the best odds of having a healthy baby.

Yikes. Like many single women trying to get by in a big city, I didn’t have $100 to spare, much less $11,000. And I could think of other things I’d do with that cash if I did have it—like take a trip around the world (which might even turn up a good mate).

Then I weighed the cost of not doing it. If I didn’t meet someone in time, there was always the option to adopt. But after talking to women who’d gone that route, I discovered it wasn’t so simple. I wasn’t financially able to go it alone—most adoptions cost upwards of $20,000—so not only would I have to find a partner, but he’d have to help foot the bill. Getting pregnant with eggs from a donor was no bargain either, starting at $15,000 at most clinics. And as I considered the idea, I realized that I’d started to think of my genes in a different light. A cancer scare had forced me to imagine life without my dad. When I pictured a son, it was a version of my father, a patient, empathetic man who admires artists as much as sports heroes.

Compared with the alternatives, $11,000 for the possibility of using my own eggs no longer seemed so terrible. After a physical, blood tests and a pelvic sonogram by my ob/gyn, I was given the green light and told that only one cycle would probably produce enough eggs. If I used a low-interest credit card, I would be paying back roughly $250 a month, about the amount I was spending now on therapy to quiet my ticking ovarian time bomb. I called FIRM and made arrangements to start my injections at the beginning of my next cycle.

That night, I slept like a baby. A looming dread was lifted. I slept the following afternoon, too, instead of joining friends at happy hour. Then I lost my nerve to contact a man who’d been weaving in and out of my thoughts. I needed to focus on work, I told myself.

Newly blasé about time and dating, it dawned on me that I was becoming…a guy. Focusing on a relationship? Nah. It wasn’t healthy to force the issue. I was marching to the beat of my own naps, which were becoming suspiciously more frequent.

A small voice nagged at me: Maybe there is a reason we are forced to face down birthdays and biological clocks, it said. They light a fire under us, jolting us out of our paralyzing fears and into the next adventure. I knew I wanted a partner, and that wasn’t going to happen while I was napping. I stalled on ordering the meds and canceled my appointment.

Instead, I got back out there: forcing myself to go to social events, saying yes to every invitation, even agreeing to my first blind date. But every time I met someone new, I became preoccupied with his paternal potential. Exactly how quickly would he be ready to have kids? Needless to say, no one seemed to do it for me. I suspected I wasn’t really doing it for them, either; I was giving off about as much chemistry as a corporate recruiter.

There was one person my imagination was still summoning, however—the guy I had been too afraid to get back in touch with. We’d become friends after he moved in next door to me the year before, but just as we seemed close to becoming something more, I was offered a four-month job 3,000 miles away. Now back in town and staring down another birthday, I got up the nerve to pay my old neighbor a visit. I was greeted by a perky young blonde in braids, who introduced herself as “the girlfriend.”

Crestfallen, I went home and collapsed on my bed. Only one thought could stop the spiral. I dug up FIRM’s number, then dialed the phone. Suddenly, the money and the odds seemed meaningless compared with the hope I needed. If freezing eggs could buy me more time to meet someone, to truly get to know someone, maybe it was worth the gamble. “When you get to be in your 40s, the money really won’t mean anything to you,” my older cousin told me. Faced with infertility at 29, she had opted out of IVF, fulfilling her desire to play a parenting role by volunteering as a mentor. “You will want to know that you considered all your options and made a choice. And then, no matter what happens, you won’t feel bad about it.” I booked a flight to Jacksonville the next day.

I found a British company online that sold my medications for about half the cost of U.S. pharmacies, and soon several boxes of vials arrived in the mail. At first, the idea of injecting myself with hormones was daunting: Needles make me squeamish. But with videos and phone walk-throughs from FIRM’s cryo-egg coordinator, Cindy Brubaker, I learned to handle the meds like a pro, and the tiny needles proved painless. By the seventh day of treatment, I felt slight twinges in my ovaries, and a sonogram showed budding little follicles, like two small bunches of grapes on the vine. On day eight, I got an e-mail message from an old friend announcing her baby’s arrival, news that would ordinarily set off some panic, but I felt genuinely excited for her. On day nine, I caught myself eyeing a muscular busboy like a predator hawk and realized my sex drive had kicked up a few notches. (I summoned the image of the septuplets that could result if I acted on it, and that was the end of that.)

When my “due date” approached, I flew to Jacksonville, feeling bloated and slightly crampy. Three days and two monitoring appointments later, my eggs reached full maturity, and I took a cab to the clinic. I rode the elevator with a woman who appeared to be in labor; I was grateful when all I had to face was an IV insertion into my hand, intended to put me into a twilight state. The last thing I recall was trying to count the rows and rows of glass tubes awaiting my eggs. Surely they wouldn’t need all of them? I woke up 30 minutes later with a small card in my hand announcing that I was the proud mother of 16 bouncing oocytes, all of them successfully frozen and safely submerged in their special vat. A wave of relief washed over me, sending me right back to sleep.

I carried my little card to the airport the next day, along with Tylenol for cramps. I felt no pain, though, only a lightness. I knew it wasn’t a guarantee, freezing those 16 eggs. And I still felt an urgency to meet someone. But the panic was gone. I had done something. I had been productive, if not yet reproductive. I had explored all the options and made a choice. Whatever transpires next, I won’t look back in regret.